Breast Cancer: Screening Policy (Hansard, 18 July 1985)

§ Baroness Ewart-Biggs
My Lords, I beg leave to ask the Question standing in my name on the Order Paper.

§ The Parliamentary Under-Secretary of State, Department of Health and Social Security (Baroness Trumpington)
My Lords, my right honourable friend the Minister for Health announced in another place on 2nd July that the Government were establishing an expert working group to consider the information now available on breast cancer screening by mammography and advise on policy options. He has asked the chairman to report as soon as possible. Any change in policy on screening must await that report.

§ Baroness Ewart-Biggs
My Lords, I thank the Minister for that very encouraging Answer. Nevertheless, does the Minister not agree that there is a need for urgent action to deal with this situation, where out of the 24,000 women who develop breast cancer annually, 14,000 die? Many of those women would not die were the disease detected in time.
Will the Minister give the House some indication of when she anticipates that the report from the working group will be published? Also, can she say how many hospital units to deal with the diagnosis and treatment of breast cancer have been closed? Will the Minister give an assurance that no further hospital units dealing with breast cancer will be closed while this very serious situation continues?

§ Baroness Trumpington
My Lords, I agree with the statements made by the noble Baroness. The working party was set up in order that a decision could be reached as soon as possible. The question of any closures is a matter for local health authorities.

§ Lord Molloy
My Lords, can the noble Baroness tell the House whether there is any truth in the apprehensions expressed by some specialists working on breast cancer, who believe that they are within an ace of curing this horrid disease without removal of the breast, and that there will be no inhibitions on the finance they require to complete their research?

§ Baroness Trumpington
My Lords, with regard to funding, each option for a screening service has implications, as the noble Lord will know, for National Health Service manpower and financing. We cannot decide what resources health authorities will need until the implications have been assessed.

§ Lord Ennals
My Lords, while warmly welcoming the establishment of the working party to which the noble Baroness has referred, may I, in support of my noble friend Lady Ewart-Biggs, ask the Minister whether she has seen the recent statement made by the director of the Cancer Research Campaign that a substantial number of the 14,000 women who die each year could be saved by a breast cancer screening 862 service; and that regular screening of women over the age of 50 by mammography has, under trial, reduced the number of deaths by at least one-third? We are dealing with some staggering figures here.

§ Baroness Trumpington
My Lords, in answer to the noble Lord, the information I have—and let us not split hairs—is that 13,277 women died from breast cancer in England and Wales in 1984. I agree that a significant number of those deaths might have been avoided if cancer had been diagnosed sufficiently early.

§ Baroness Masham of Ilton
My Lords, should there be a non-profit making breast cancer screening service, might not some women who could pay contribute towards it?

§ Baroness Trumpington
My Lords, no doubt that is one of the matters which might be discussed by the working party.

§ Lord Rea
My Lords, is the noble Baroness aware that there has been a considerable improvement in treatment for breast cancer recently? I can give evidence of patients who are surviving very well using anti-oestrogen treatment. Will the noble Baroness see to it that her right honourable friend makes sure he anticipates that the committee will recommend more funding, and be prepared for that as part of the inevitable increase in health service expenditure which is necessary as new technology is developed?

§ Baroness Trumpington
My Lords, I will see to it that my right honourable friend reads the noble Lord's remarks.

§ Baroness Ewart-Biggs
My Lords, will the noble Baroness assure the House that the research already done in the United States, Sweden and Holland, where it has been proved that mammography screening is most effective, will be taken into account by our own working groups, and that the cost will not deter the Government from taking that method seriously into account?

§ Baroness Trumpington
My Lords, the previous studies in the United States produced conflicting evidence on the effectiveness of mammographic screening, but the recent Swedish study, which I know the noble Baroness is aware of, has removed many of the doubts previously attached to the value of mammographic screening. However, it is right to ask leading United Kingdom experts to confirm its scientific validity, and that screening would be similarly effective in the United Kingdom.